and americans tend to forget, particularly given the debates over what our health world might looklike , we tend to forget it is still a state-by-state practice. doctors are separately licensed in each separate state and if they go to another state they have to get relicensed or recertified in that state and the requirements forlicensing very from state to state. in some states , they license all levels of medical care. some license only son. the criteria arestill surprisingly local , at least on a state-by-state basis. i like in the law that was passed, i liken it to sort of a faith-based that on the future. that if we allow medicine to transform itself into a profession and base it on science, that you will ultimately help the public health of the population. >> it does but it does much later than most people realize. >> there's a great debate among medical historians about what benefit does the average patient of the average illness going to the average doctor. at one point does the patient benefit from that. >> and there are different answers depending what it is. insurgency surger